Post operative drainage tubes with suture strip and method of use

ABSTRACT

Post-operative drainage tubes, e.g., thoracic catheters, intercostal catheters and sump drain tubes, have a suture strip secured in piggy-back relation thereto. The drainage tube may then be fixed to the body of a patient by a suture which engages the suture strip, e.g., by being threaded through the joint between the suture strip and the drainage tube.

United States Patent 1 Sheridan Dec. 11, 1973 1 1 POST OPERATIVE DRAINAGE TUBES WITH SUTURE STRIP AND METHOD OF USE [76] Inventor: David S. Sheridan, Hook Rd.,

Argyle, NY. 12809 [22] Filed: July 18, 1972 [21] Appl. No.: 272,871

[52] U.S. Cl. 128/350 R, 128/DIG. 26 [51] Int. Cl A6lm 25/02 [58] Field of Search 128/348, 349 R, 350 R,

128/351, 334, 335, 335.5, 303 R, DIG. 26; 174/47, 41, 70 A [56] References Cited UNITED STATES PATENTS 3,580,983 5/1971 Jackson 174/47 3,176,690 4/1965 HDoubler 128/348 3,136,316 6/1964 Beall 128/350 R 3,114,373 12/1963 Andersen 128/350 R FOREIGN PATENTS OR APPLICATIONS 458,201 3/1928 Germany 128/350 R 747,691 4/1956 Great Britain 174/41 Primary ExaminerDalt0n L. Truluck Attorney-Solon B. Kemon et a1.

[57] ABSTRACT Post-operative drainage tubes, e.g., thoracic catheters, intercostal catheters and sump drain tubes, have a suture strip secured in piggy-back relation thereto. The drainage tube may then be fixed to the body of a patient by a suture which engages the suture strip, e.g., by being threaded through the joint between the suture strip and the drainage tube.

6 Claims, 9 Drawing Figures POST OPERATIVE DRAINAGE TUBES WITH SUTURE STRIP AND METHOD OF'USE BACKGROUND OF THE INVENTION 1 .'Field of the Invention This invention'relates to improvements in the construction of post-operative drainage tubes, e.g.,'thoracic catheters, intercostal catheters and sump drain tubes, and to new methods for securing post-operative drainage tubes in position relative to the body of a patient into which a drainage tube has been inserted.

2.Description of the Prior Art There are a variety of medico-surgical tubeswhich are employed in connection with surgical operations for post-operative drainage purposes to remove fluids and other matter from body cavities of a patient. These include thoracic catheters intercostal catheterstsee U.S. Pat. Nos. 3,190,290 and 3,295,527) and sump drain catheters (see U.S. Pat. No. 3,314,430). Such drainage tubes may be provided with special features such as a capped proximal end to permit smooth installation in a patient without ripping, coring or tearing of body tissue of the patient (see U.S. Pat. No. 3,589,368). The improvements of the present invention may be applied to all of these forms of postoperative drainage tubes and similar medico-surgical tubes which now exist or may be developed in the future.

Post-operative drainage tubes when placed in a patient for removal of fluid from body cavity of the patient must be made secure so they cannot slip outward or penetrate further into the body. The existing drainage tubes do not provide means for readily and safely accomplishing the required fixing of the position of the drainage tube relative to the patients body. It is standard practice for the surgeon or other person installing a post-operative drainage tube in a patient to stitch a suture through the skin or other tissue of the patient and then tie an end of the suture around the drainage tube. Such a procedure is awkward and may not insure a satisfactory securement in the position of the drainage tube because of the possibility of slippage between the loop of the suture relative to the wall of the drainage tube. Accordingly, there is a need for improvements in methods by which post-operative drainage tubes can be fixed in position relative to the body of the patient and in the construction of such tubes to render them adaptable to new methods of securement.

OBJECTS A principal object of this invention is the provision of new improvements in post-operative drainage tubes. Further objects to include the provision of:

I. New methods for securing post-operative drainage tubes in position relative to the body of a patient in which a drainage tube has been inserted.

2. Thoracic catheters, intercostal catheters, sump drain tubes and similar medico-surgical devices with improved construction rendering them capable of easy securement by surgeon or other person to the body of a patient in which the tube has been inserted for postoperative drainage purposes.

Other objects and further scope of applicability of the present invention will become apparent from the detailed description given hereinafter; it should be understood, however, that the detailed description, while indicating preferred embodiments of the invention, is

given by way of illustration only, since variouschanges the central body portion 14.

and modifications within the spirit and scope of the invention will become apparent to those skilled in theart from this detailed description.

SUMMARY OF THE INVENTION These objects are accomplished according to the present invention by providing post-operative drainage tubes comprising an elongated tubular member formed of non-fibrous flexible water-proof plastic material with a suture strip formed of flexible water-proof plastic material secured to j the exterior surface of the tubular member in superimposed relationship, i.e., piggy-back relation, with a joint between the tubular member and the suture strip which is capable of easy penetration by a'suture needle to permit securing the drainage tube by suturing to the body of a patient into which the drainage tube is inserted.

The objects are also accomplished by a method of securing post-operative drainage tubes to the body of a patient to which the drainage tubes isinserted comprises:

a. providing a suture strip formed of flexible waterproof plastic material secured to the exterior surface of the drainage tube in piggy-back relation therewith and b. securing the drainage tube to the body of a patient into which the drainage tube is inserted by a suture which engages the suture strip.

In one embodiment of the invention, the new drainage tube securing method involves penetrating the joint between the suture strip and the drainage tube witha suture needle and threading the suture which secures the drainage tube to the patient through the openingin the joint formed by the needle penetration. In another embodiment, a short portion of the suture strip is released from the drainage tube by cutting the joint between the suture strip and the drainage tube and the suture attached to the body of the patient is tied to the released short portion of the suture strip.

BRIEF DESCRIPTION OF THE DRAWING FI GI4 is a fragmentary side view illustrating an- :7

other method of use of a drainage tube of the invention.

FIG. 5 is a fragmentary side view illustrating yet another method of use of a drainage tube of the invention. FIGS. 6-8 are sectional end views illustrating various cross-sectional shapes of suture strips for postoperative drainage tubes of' the invention.

FIG. 9 is an enlarged sectional end view of a modified form of drainage tube of the invention.

DESCRIPTION OF PREFERRED EMBODIMENTS A post-operative drainage tube 2 of the invention comprises an elongated tubular member 4 having a distal end 6 provided with fluid entrance eyes 8 and a proximal end 10 provided with a closure cap 12 (see U.S. Pat. No. 3,589,368) joined to the distal end 6 by A suture strip 16 made of flexible water-proof plastic material is secured to the exterior surface 18 of the tubular member 4 in superimposed or piggy-back relationship. The suture strip 16 may be placed on the tubular member 4 by continuous extrusion of both through a suitably shaped die. Alternatively, the tubular member 4 and suture strip 16 may be separately formed, preferably by extrusion, and may be attached together such as by thermal welding or solvent cementing. Advantageously, tubular member 4 is formed of clear, transparent plastic material while the suture strip is colored for contrast with a dye. Alternatively, a suture strip 16 may also be clear or it may be rendered opaque by addition of fillers including X-ray opaque fillers such as barium compounds, tin powder and the like. Suture strips may run parallel with the tubular member 14 as shown in FIG. 1 or may be manually placed and welded as a ring 20 as seen in FIG. 9. A plurality of such rings may be spaced along the tubular member 4 being distributed at portions of the drainage tube 2 where it is most likely the drainage tube will exit through the chest or abdomen of a patient in which the tube has been inserted.

FIG. 2 illustrates the use of a suture strip 16 of circular cross-section. Suture strips of other cross-sections may, however, be employed such as the oval crosssection strip 22 of FIG. 6, the square or rectangular cross-section strip 24 of FIG. 7 or the triangular crosssection strip 26 of FIG. 8. The oval or round configuration is preferred to eliminate any possible tissue damage due to sharp edges and also improves the ease of placement of the point of a suture needle in the operation of securing the drainage tube to the body of a patient.

Small sections of the suture strip 16 may be removed so as to create a marking or indication 28 of some predetermined position in the distal end of the drainage tube, the location of a specific eye 8A or similar feature of the drainage tube. Where the suture strip 16 would contain X-ray opaque filler, the removed marker portion 28 could be determined or located with the drainage tube installed in the body ofa patient by X-ray film or fluoroscoping.

The strength with which the joint between the tubular member 4 and the suture strip 16 is formed can be varied either in the integral extrusion method, welding method or cementing method. For example, in the integral extrusion method, the area of contact between the suture strip 16 and the tubular member 4 may be varied at the joint 30 between them. In the thermal welding method, the strength of the joint can be controlled by the heat and pressure used in welding the suture strip to the tubular member. In the cementing procedure, the amount and/or type of solvent or cement used to form the joint may be varied to obtain the desired strength of joint. Advantageously, the strength of the joint 30 between the tubular member 4 and the suture strip 16 will be controlled so that the suture strip 16 would under no condition of normal use of the drainage tube 2 accidentally separate, but the joint would becapable of easy penetration by a suture needle (see FIG. 2) or could be cut without difficulty permitting the suture strip 16 to be peeled from the tubular member 4 (see FIGS. 4 and Those skilled in the art of fabrication of extruded tubes of plastic material will have no difficulty in obtaining a desired controlled strength of joint between the suture strip and tubular member following a brief testing of joint strengths to accommodate the fabrication procedures to specific flexible waterproof plastic materials being employed in the operations.

The novel form of post-operative drainage tubes of the invention make possible new methods of securing such tubes to the body of a patient into which the drainage tube is inserted for removal of fluids or other matters from body cavities of the patient. Variations of the method are possible as illustrated in FIGS. 2-5. In all of the methods, securement of the drainage tube to the patients body is attained by engaging the suture strip 16 with a suture that also engages tissue of the patients body. Variations in the new methods involve different ways in which the suture may engage the suture strip. As illustrated in FIGS. 2 and 3, this may be accomplished by penetrating the joint 30 between the suture strip and tubular member 4 with a suture needle 32 to thread the suture 34 through an opening in the joint 30 formed by the needle penetration. As shown in FIG. 3, the suture 34 can also be threaded through the skin 36 adjacent the opening in the flesh 38 of the patient through which the proximal end 10 of the drainage tube 2 extends.

In another embodiment of the methods, a short portion 40 of the suture strip 16 may be released without breakage from the drainage tube by cutting the joint 30 between the suture strip 16 and the tubular member 4 to form a small unattached loop 42 through which the suture 34 may be passed for attachment to the body of a patient in a similar manner as illustrated in FIG. 3.

In another embodiment of the new methods, a short portion 44 of the suture strip 16 may be released by cutting through the joint 30 between the suture strip 16 and the tubular member 4 and the resulting loop severed to create an unattached end 46. One or more sutures 34 may be tied or looped around this short portion 44 of the suture strip 16 and these in turn attach to the body of a patient by threading through the skin or flesh as illustrated in FIG. 3.

Tubular members 4 and suture strip 16 are preferably made from the same flexible water-proof plastic material, exclusive of any dye which may be contained in the suture strip in order to provide contrast between the strip and the tubular member 4. However, it is possible to make the suture strip from different plastic material than the tubular member 4. Advantageously, the plastic material utilized in forming the tubular member 4 will be clear plastic free of dyes and pigments so that the tube will be transparent to permit visual inspection of the tube for possible obstruction or foreign matter within the bore of the tube. Dyes, however, can be incorporated in the plastic material of which the tubular member 4 is made without destroying the transparency should it be desired to give a distinct color to tubular member for color coding or other purposes. Any suitable flexible plastic material may be used in the formation in the new drainage tubes such as vinyl chloride homopolymers or copolymers with other vinyl esters such as vinyl acetate and particularly such polymers which have been compounded with suitable plasticizers to give polymers which have been compounded with suitable plasticizers to give good flexibility to the tubes over a broad range of temperatures. Other plastic materials from which the products can be formed include flexible or pliable forms of nylon, polyolefin resins, polyurethanes, polyester plastics, acrylic polymers, cellulose esters, vinylidene chloride polymers and the like. Eyes or openings 8 in required number may be formed in any suitable manner in the drainage tubes (see U.S. Pat. No. 3,375,828) and a portion or the whole of one or both inner and outer surfaces of the drainage tube may be provided, if desired, with a frosted surface (see U.S. Pat. No. 3,508.554).

The embodiments of the invention in which an exclusive property or right is claimed are defined as follows:

1. In a post-operative drainage tube comprising an elongated tubular member formed of non-fibrous flexible water-proof plastic material, a proximal end portion adapted to be pulled through the body of a patient when the tube is inserted for drainage of material from the patient and a distal end portion comprising side openings in the tubular member through which material can enter the drainage tube from the patient, the improvement which comprises a suture strip formed of flexible waterproof plastic material welded to the exterior surface of said tubular member in superimposed relationship therewith, the joint between said tubular member and suture strip being capable of easy penetration by a suture needle to permit securing of the drainage tube by suturing to the body ofa patient into which the drainage tube is inserted.

2. A drainage tube of claim 1 wherein said tubular member is made of colorless, transparent plastic material.

3. A drainage tube of claim 2 wherein the plastic material of said suture strip contains a dye whereby the suture strip is clearly distinguishable by color from the colorless tubular member.

4. In a post-operative drainage tube comprising an elongated tubular member formed of non-fibrous flexible water-proof plastic material, a proximal end portion adapted to be pulled through the body of a patient when the tube is inserted for drainage of material from the patient, said proximal end portion comprising a closure cap, and a distal end portion comprising side openings in the tubular member through which material can enter the drainage tube from the patient, the improvement which comprises a suture strip formed of flexible waterproof plastic material, said strip being substantially circular in cross-section and welded to the exterior surface of said tubular member in superimposed relationship therewith substantially entirely along the length of said tubular member, the joint between said tubular member and suture strip being substantially a tangential contact between the member and strip capable of easy penetration by a suture needle to permit securing of the drainage tube by suturing to the body of a patient into which the drainage tube is inserted.

5. A drainage tube of claim 4 wherein said suture strip has a small section adjacent the distal end of the drainage tube removed to create an indication of the location of a side opening in said tubular member.

6. A drainage tube of claim 4 wherein said tubular member is formed of transparent, colorless plastic material and said suture strip is colored so that it is clearly distinguishable from the tubular member. 

1. In a post-operative drainage tube comprising an elongated tubular member formed of non-fibrous flexible water-proof plastic material, a proximal end portion adapted to be pulled through the body of a patient when the tube is inserted for drainage of material from the patient and a distal end portion comprising side openings in the tubular member through which material can enter the drainage tube from the patient, the improvement which comprises a suture strip formed of flexible waterproof plastic material welded to the exterior surface of said tubular member in superimposed relationship therewith, the joint between said tubular member and suture strip being capable of easy penetration by a suture needle to permit securing of the drainage tube by suturing to the body of a patient into which the drainage tube is inserted.
 2. A drainage tube of claim 1 wherein said tubular member is made of colorless, transparent plastic material.
 3. A drainage tube of claim 2 wherein the plastic material of said suture strip contains a dye whereby the suture strip is clearly distinguishable by color from the colorless tubular member.
 4. In a poSt-operative drainage tube comprising an elongated tubular member formed of non-fibrous flexible water-proof plastic material, a proximal end portion adapted to be pulled through the body of a patient when the tube is inserted for drainage of material from the patient, said proximal end portion comprising a closure cap, and a distal end portion comprising side openings in the tubular member through which material can enter the drainage tube from the patient, the improvement which comprises a suture strip formed of flexible waterproof plastic material, said strip being substantially circular in cross-section and welded to the exterior surface of said tubular member in superimposed relationship therewith substantially entirely along the length of said tubular member, the joint between said tubular member and suture strip being substantially a tangential contact between the member and strip capable of easy penetration by a suture needle to permit securing of the drainage tube by suturing to the body of a patient into which the drainage tube is inserted.
 5. A drainage tube of claim 4 wherein said suture strip has a small section adjacent the distal end of the drainage tube removed to create an indication of the location of a side opening in said tubular member.
 6. A drainage tube of claim 4 wherein said tubular member is formed of transparent, colorless plastic material and said suture strip is colored so that it is clearly distinguishable from the tubular member. 